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I am a 55 year old woman diagnosed 6 years ago with migraine headaches. In the last year I have been having almost daily headaches. I have pressure to the right side of my head, neck and behind my right eye. About twice a month I can't put my head down or back or I get sharp throbbing pressure pain in my head. I saw a neurologist, and he did a MRI and a MRA in 01/06. The findings were normal, but it was noted in the report (MRI) that there was a prominent flow void seen associated with supraclinoid right carotid artery, probably due to tortuosity of the vessel. The MR angiogram was normal except noted that a abnormal superclinoid carotid artery. My general doctor and a pain specialist have both told me that the condition is something that they wouldn't do anything about unless my symtoms change. I don't know what those symtom changes might be or if I need to follow up and keep an eye on it. Do you think my new headaches might be associated with this condition?

I would be foolish to speculate on any specific case which I have not had the opportunity to personally evaluate, however I can say that most people have anatomical variants on "normal" which mean nothing in terms of illness and disease. The brain is supplied by six interconnecting large arteries and the loss of one usually makes little difference. The important thing is to rule out any life-threatening cause for these headaches and it seems that has been done. One should pay attention to blood pressure as well. The best approaches to true migraines, in my opinion, are detoxification (heavy metals and organic toxins) acupuncture (but only in the hands of a very skilled acupuncturist and these people are hard to isolate and find among all the amateurs calling themselves acupuncturists), and food sensitivites (not "allergies" necessarily) - and the best method I know of for this is electrodermal screening.